Henricks, Evan

Henricks, Evan is an individual health care provider with primary practice located at 9200 W Wisconsin Ave Division Of Geriatrics, Milwaukee WI 53226-3522. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Henricks, Evan can be contacted via phone (414) 805-6850.

Contact Information

Primary practice address
9200 W Wisconsin Ave Division Of Geriatrics Milwaukee WI 53226-3522
Phone: (414) 805-6850
Fax: (414) 805-6864
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 70409 Wisconsin
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 70409 Wisconsin

Profile Details

NPI number 1578094835
LBN Legal business name Henricks, Evan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2017
Last updated Sep 12th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578094835 NPPES
Wisconsin MEDICAID 1578094835

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